JP2020531199A - Guide attachment for electric tools - Google Patents

Abstract

The distal targeting device for surgical instruments has a magnetic field generator with a coupling element configured to receive an elongated shaft along the axis and a magnetic field so as to be proximal to the axis and away from the magnetic field generator. Includes a bridge that can be connected to the generator. The bridge includes an attachment device that can be connected to a tool configured to operate the shaft. The bridge also includes a pair of arms configured to fasten the body of the tool in such a way that the bridge is substantially tightly connected to the tool. At least one of the arms can be placed with respect to the attachment member at an adjustable distance so that the arm allows the tool body having one or more of various shapes and sizes to be substantially secured.

Description

The present disclosure relates to a distal targeting device for use with a surgical implant, more particularly with an adjustable attachment device for attaching the distal targeting device to electric tools of various sizes and / or shapes. Regarding the position targeting device.

Surgical implants may include mechanisms that require external manipulation during or after implantation. For example, an implant may be a fixation element, a locking element, a positioning element, or another type of element that allows the implant to operate in a manner that facilitates healing and / or stabilization of the patient's anatomy. Alternatively, a mechanism can be included. An example of such an implant is an intramedullary nail that is implanted in the intramedullary cavity of a long bone, such as the femur, to stabilize the fractured part of the bone. By passing a locking member such as a screw through at least an access hole perforated through the cortex of the bone and aligning it with a fixing hole such as a screw hole pre-perforated laterally into the nail, the bone It has been common practice to fix intramedullary nails. In such a procedure, pre-drilled holes in the intramedullary nail are generally invisible to the surgeon, and the location of these holes is localized to drill an access hole in the bone and / or insert a locking member. There have been technical difficulties due to the difficulty of aligning with surgical drills and placement instruments for.

Distal targeting systems are often used to detect the location of different elements of an implant during a surgical procedure. For the intramedullary nail example above, a distal targeting system can be used with a surgical drill to locate one or more fixation holes within the intramedullary nail and the distal end of the drill bit of the surgical drill. Feedback can be provided to the physician indicating the relative position of the fixation hole with respect to. Such a distal targeting system can include a magnetic field generator (also simply referred to as a "field generator") having a central guide hole that receives the drill bit. The magnetic field generator includes a circuit for generating one or more magnetic fields. The intramedullary nail can include one or more sensors, each having one or more magnetic field transponders configured to detect the direction and intensity of the magnetic field generated by the magnetic field generator. Each such one or more sensors can transmit magnetic field data to a control unit having a control circuit. Such one or more sensors can be positioned relative to the intramedullary nail so that the relative positions of the one or more sensors and the one or more fixation holes are known to the control unit. The orientation and position of the central axis of the guide hole is also known to the control unit. The central axis of the guide hole coincides with the central axis of the drill bit received in the guide hole.

The control unit interprets data from one or more sensors to determine the orientation and displacement of the central axis of the guide hole with respect to one or more fixation holes in the intramedullary nail. The control unit sends feedback to the physician indicating the orientation and / or displacement of the central axis with respect to the fixation hole in the intramedullary nail, such as visual feedback via the view screen or audio feedback via the speaker. Distal targeting systems for use with other types of surgical implants can use similar structures and techniques.

In one embodiment of the disclosure, the distal targeting device of a surgical instrument is a magnetic field generator with a coupling element configured to receive an elongated shaft along the axis and a magnetic field proximal to the axis. Includes a bridge that can be connected to the magnetic field generator so as to be separated from the generator. The bridge includes an attachment device that can be connected to a tool configured to operate the shaft. The bridge also includes a pair of arms configured to fasten the body of the tool in such a way that the bridge is substantially tightly connected to the tool. At least one of the arms can be placed with respect to the attachment member at an adjustable distance to allow the arm to substantially secure the tool body having one or more of different shapes and sizes.

In another embodiment of the present disclosure, the magnetic field generator configured to align the target with the shaft of the surgical instrument is close to the housing containing the magnetic field generation circuit and the openings separated from each other along the longitudinal direction. Includes a coupling element that at least partially defines the opening having a position end and a distal end of the opening. The opening is open in a transverse direction substantially perpendicular to the longitudinal direction to accept the shaft without passing the distal or proximal end of the shaft through the opening.

In a further embodiment of the present disclosure, the distal targeting system comprises a tool body and an electric tool having a receiving element. The system includes an elongated shaft along an axis that extends along the longitudinal direction. The proximal portion of the shaft is acceptable to the receiving element of the power tool. The system includes a magnetic field generator with a coupling element configured to accept the shaft. The system also includes a bridge that can be connected to the magnetic field generator so as to be proximal to the axis away from the magnetic field generator. The bridge includes an attachment device that can be connected to the drive tool and a pair of arms configured to hold the tool body in a manner that substantially tightly connects the bridge to the tool. At least one of the arms is a second tool body in which the arm 1) holds the tool body substantially tightly, 2) releases the tool body, and 3) has one or more of a size and shape different from the tool body. Can be placed with respect to the attachment device at an adjustable distance to allow for a substantially tight fit.

A deeper understanding of the above overview and the following detailed description of exemplary embodiments of the distal targeting apparatus of the present application will be obtained in conjunction with the accompanying drawings. Illustrative embodiments are shown in the drawings for purposes of illustrating the expandable facet implants of the present application. However, it should be understood that the application is not limited to the exact arrangement and means illustrated. The drawings are as follows.
FIG. 5 is a perspective view of a distal targeting device according to an embodiment of the present disclosure that constitutes a distal targeting system when connected to an electric tool. It is a top view of the distal targeting device of FIG. FIG. 5 is a plan view of the distal targeting device of FIG. 1 in which the clamp arm of the device is in the extended position. It is a perspective view of the element of the attachment device of the distal targeting device of FIG. It is an exploded view of the bridge of the distal targeting device of FIG. It is a side sectional view of the proximal part of the bridge of the distal targeting device of FIG. The first step of assembling the attachment device is a partially exploded view of the bridge of FIG. 5, which is shown according to one exemplary assembly sequence. The second step of assembling the attachment device is a partially exploded view of the bridge of FIG. 5, which is shown according to an exemplary assembly sequence. A third step of assembling the attachment device is a partially exploded view of the bridge of FIG. 5, which is shown according to an exemplary assembly sequence. A fourth step of assembling the attachment device is a partially exploded view of the bridge of FIG. 5, which is shown according to an exemplary assembly sequence. A fifth step of assembling the attachment device is a perspective view of the bridge of FIG. 5, which is shown according to an exemplary assembly sequence. It is an exploded view of the magnetic field generator of the distal targeting apparatus of FIG. It is a rear partial perspective perspective view of the assembled magnetic field generator of FIG. FIG. 12 is a partial cross-sectional end view of the coupling element of the magnetic field generator of FIG. 12, showing a slot for receiving a shaft of an electric tool. FIG. 12 is a rear view of the magnetic field generator of FIG. 12, with the rear housing cover of the magnetic field generator removed and the shaft mount shown in the open position. It is the same rear view as FIG. 15 which shows the shaft mount in a closed position. FIG. 14 is a partial cross-sectional end view of the coupling element of FIG. 14, showing a shaft fully seated in the slot and a shaft mount in a closed position. It is a perspective side sectional view of the coupling element of the magnetic field generator of FIG. Another perspective sectional view of the coupling element with the shaft fully seated in the slot. FIG. 5 is a side sectional view of a holding element for holding the position of a shaft within a coupling element of a magnetic field generator according to another embodiment of the present disclosure. FIG. 3 is a partial front perspective view of a coupling element of a magnetic field generator according to another embodiment of the present disclosure. It is a front view of the coupling element of FIG. It is a plane partial perspective view of the magnetic field generator of FIG. 12 showing the linkage of the magnetic field generator in the urging position before being connected to the bridge of FIG. FIG. 2 is a planar perspective view of the magnetic field generator and the bridge of FIG. 23 showing a coupler of a bridge engaged with the linkage of the magnetic field generator in a manner that moves the linkage away from the urging position. FIG. 23 is a planar partial perspective view of the magnetic field generator and the bridge showing the linkage of the magnetic field generator at the latch position with respect to the coupler of the bridge. FIG. 2 is a planar partial perspective view of the magnetic field generator and the bridge of FIG. 23 showing the linkage of the magnetic field generator in a fully open position for separating the bridge from the magnetic field generator. FIG. 5 is a perspective view of a distal targeting device coupled to an electric tool according to another embodiment of the present disclosure. FIG. 27 is a cross-sectional end view of the distal targeting device of FIG. 27 showing the clamp arm of the device in the closed position. FIG. 27 is a cross-sectional end view of the distal targeting device of FIG. 27 showing a clamp arm in another position and a clamp arm in an optional fully open position with a dashed line. FIG. 5 is a perspective view of a distal targeting device coupled to an electric tool according to another embodiment of the present disclosure. FIG. 30 is a partial cross-sectional end view of the distal targeting device of FIG. 30 showing the clamp arm of the device in the closed position and in the open position with a dashed line. FIG. 30 is a plan view of the distal targeting device of FIG. It is a perspective sectional view of the coupling element of the distal targeting apparatus along the cutting line 33-33 of FIG. 32, the coupling element is configured to hold a magnetic field generator. FIG. 3 is another cross-sectional view of the coupling element of FIG. 33. FIG. 30 shows a cross-sectional view of the coupling element of FIG. 34 connected to the branch portion of the bridge of the distal targeting device of FIG. It is a perspective view of a distal targeting device using a tether to connect the device to an electric tool according to another embodiment of the present disclosure, the tether is shown in a loosely attached state. FIG. 36 is a perspective view of the distal targeting device of FIG. 36 showing a tether in a tightened state. FIG. 36 is a plan view of the distal targeting device of FIG. 36 with the tether and tether tensioning mechanism removed for exemplifying purposes. It is a partial side view of the attachment device of the distal targeting device of FIG. FIG. 3 is a rear perspective view of a display assembly for use with the distal targeting device of the above figure, according to an embodiment of the present disclosure. It is a perspective view of the display screen of the display assembly of FIG. It is a perspective view of the display assembly of FIG. 40 connected to the distal targeting device of FIG.

In the procedure of distal targeting of implants with surgical instruments, it is advantageous to provide the most accurate possible relationship between the implant and the surgical instrument. The present disclosure will align the distal portion of a surgical instrument, such as the distal end of a drill bit, with a portion of a surgical implant placed within the patient's body by attaching it to a surgical instrument such as an electric drill. With respect to a distal targeting device that can guide the surgeon. Specifically, each of the distal targeting devices disclosed herein allows the targeting device to be easily mounted in a sturdy and robust manner on surgical instruments of different sizes and / or shapes. It has an adjustable mounting element. This allows a physician to use the distal targeting device and any one of many surgical instruments as one distal targeting system. As a non-limiting example, most electric drills designed to drill access holes in the cortex of bone have a width of each tool in the range of about 2.50 cm to about 5.12 cm, such as in motor cowling. It is manufactured commercially so that The mounting elements of the distal targeting device disclosed herein can be sized to be coupled with power having a width in the aforementioned range. Therefore, the mounting elements for distal targeting devices disclosed herein can be characterized as "general purpose mounting elements". The distal targeting devices disclosed herein offer a great commercial advantage as the same targeting device can be used for most of the commercially available electric drills in the surgical field, such as the field of intramedullary nail implantation. Is.

The present disclosure also relates to a magnetic field generator of a distal targeting device. Specifically, the magnetic field generators disclosed herein are alternatives that require approximately the entire drill bit to be inserted axially through the opening, distal to first or proximal to first. Includes a lateral inlet opening that allows a portion of the drill bit to be inserted laterally into the magnetic field generator. In addition, the magnetic field generators disclosed herein are equipped with a distal targeting device such that the magnetic field generator is supported by a mounting element with the drill bit extending through the opening of the magnetic field generator. Can be connected to the element. As a result, the magnetic field generator substantially does not exert a bending moment on the drill bit during operation. Therefore, no assistant is required to manually stabilize the magnetic field generator while the doctor is operating the electric drill.

Referring now to FIG. 1, an embodiment of a distal targeting system including a distal targeting device 2 mounted on a tool 4 configured to accept and operate a shaft 6 for insertion into the patient's body is shown. Has been done. As shown in the figure, the tool 4 may be an electric tool for rotating the shaft 6, such as a hand-operated electric drill. The shaft 6 may be a bit such as a drill bit, a driver bit, or any other type of shaft for targeting and inserting into the patient's body. The power tool 4 can include a receiving element such as a chuck 8 for receiving the proximal portion 10 of the shaft 6. The shaft 6 defines a distal end 12 that is distally separated from the proximal portion 10. The distal targeting device 2 can include a magnetic field generator 14 for generating a magnetic field as described above. The magnetic field generator 14 includes a coupling element 16 configured to accept a portion of the shaft 6. The shaft 6 defines a shaft shaft 18 extending along the longitudinal direction X.

The distal targeting device 2 includes a mounting element 20 extending from the magnetic field generator 14 in the proximal direction opposite to the distal direction. It should be understood that the proximal and distal directions are bidirectional, one-way components of the longitudinal direction X, respectively. The mounting element 20 is configured to mount the magnetic field generator 14 on the main body 21 of the electric tool 4. Therefore, the mounting element 20 is also referred to herein as a "bridge." In the embodiment shown in the figure, the bridge 20 is mounted on the upper portion 22 of the tool body 21, such as a motor cowling. However, in other embodiments, the bridge 20 can also be attached to another portion of the tool body 21, such as the base 24 of the handle 26. The bridge 20 is adjustable so that the magnetic field generator 14 can be mounted on a different size and / or differently shaped electric tool 4.

The bridge 20 can also define a pair of distally extending branches 28 that extend outward with respect to lateral Y, which is substantially perpendicular to longitudinal X. The longitudinal direction X and the lateral direction Y can be referred to as "horizontal" directions, respectively. In addition, any plane having the same spread in both the longitudinal direction X and the lateral direction Y can be called a horizontal plane. The longitudinal direction X and the lateral direction Y are perpendicular to the vertical direction Z, respectively. As used herein, the term "longitudinal" means "along the longitudinal direction X." The term "horizontally" means "along the lateral direction Y" and the term "vertically" means "along the vertical direction Z". As used herein, "vertical-longitudinal plane" means a plane extending along vertical Z and longitudinal X, and vertical-horizontal plane means along vertical Z and lateral Y. It means an extending plane.

The distal end 30 of the branch 28 can be connected to the magnetic field generator 14, as described in more detail below. The branching portions 28 can define a lateral space 32 between them, whereby the shaft 6 is moved from the electric tool 4 through the lateral space 32 into the coupling element 16 of the magnetic field generator 14. Can be extended. The bridge 20 can include an attachment device 34 that can be connected to the tool body 21 and the pair of clamp arms 36. The attachment device 34 can be configured to fasten the tool body 21 in such a way that the arm 36 is operated to substantially firmly connect the bridge 20 to the tool 4. In this way, the attachment device 34 and the clamp arm 36 can work together to define the clamp.

As shown in FIGS. 2 and 3, the arm 36 can be configured to clamp the tool body 21 between the arms 36 or to contact both sides of the tool body 21 so as to otherwise fasten it. One or both of the arms 36 can be positionally adjustable with respect to the attachment device 34 to clamp tools 4 of different sizes and / or shapes. For example, each arm 36 has a lateral Y from a central vertical-longitudinal plane P (ie, a plane having the same spread as the shaft axis 18 and extending along the vertical direction Z) to the inner contact surface 38 of the arm 36. The respective arm distances D1 and D2 measured along the can be defined. The vertical direction Z is substantially perpendicular to the longitudinal direction X and the lateral direction Y. The inner contact surface 38 of the arm 36 can define a curved concave cross-sectional shape in a vertical-horizontal plane. The above cross-sectional shape can improve the fastening grip of the arm 36 to the tool body 21, especially when the tool body 21 has a rounded convex contour in a vertical-horizontal plane. The inner surface 38 of the arm 36 can also include a layer of high friction material to increase the fastening grip of the arm 36 with respect to the tool body 21.

Continuing with reference to FIGS. 2 and 3, both of the arms 36 are operated by the attachment device 34, so that the respective arm distances D1 and D2 can be adjusted and clamped to the electric tool 4 as needed. .. In the embodiment shown in the figure, the arm distances D1 and D2 can be adjusted between a minimum value of about 1.00 cm (FIG. 2) and a maximum value of about 3.50 cm (FIG. 3), respectively. As mentioned above, this range of arm distances D1 and D2 is for mounting the bridge 20 on most of the power tools 4 used with intramedullary nails, including power tools 4 with different shapes and / or sizes. Is enough. In other embodiments, one of the arms 36 may be fixed and the other may be adjustable to clamp the power tool 4. The arm 36 and the attachment device 34 can both define a rack and pinion mechanism for adjusting the arm distances D1 and D2. Specifically, each arm 36 can define an adjustment portion 40 configured to extend along the lateral direction Y and engage with the actuator 42 of the attachment device 34. The adjusting portion 40 of each arm 36 can define a rack 44 having linearly aligned rack teeth 46. The actuator 42 may include an actuating shaft 48 (shown in FIG. 5) holding a pinion 50 having radial pinion teeth 52 configured to mesh with the rack teeth 46. The actuator 42 may include a knob 54 connected to a pinion 50. The knob 54 allows the pinion 50 to be manually rotated about the central axis 56 (FIG. 5) of the actuating shaft 48, which allows the clamp arm 36 to be translated to adjust the arm distances D1 and D2.

Next, referring to FIG. 4, the attachment device 34 is configured to prevent the arm 36 from moving laterally outward after the arm 36 is clamped to the tool body 21 to prevent arm expansion such as a ratchet. Can include a vessel. Such a ratchet may include ratchet teeth 58 provided around the actuating shaft 48 at intervals in the circumferential direction. The ratchet teeth 58 can be arranged vertically between the pinion 50 and the knob 54. The ratchet can include a claw 60 configured to engage the ratchet teeth 58 and a claw spring 62 connected to the claw 60. The claw 60 allows the pinion 50 to rotate in the first rotation direction R1 so that the arm distances D1 and D2 decrease, while in the second rotation direction R2 opposite to the first rotation direction R1. It can be configured to engage the ratchet 58 so as to prevent the pinion 50 from rotating along it. It should be appreciated that although there is only one claw 60 in the embodiment shown in the figure, additional claws 60 may be used to engage the ratchet teeth 58. Actuator 42 may include a stem 64 extending below the pinion 50. The actuator 42 may also include a flange 66 at the lower end of the stem 64.

Next, referring to FIGS. 5 and 6, the body 68 of the bridge 20 can define a frame 70 configured to support the components of the attachment device 34. The lower surface 71 of the frame 70 can be contoured to fit the upper surface of the electric tool 4. Since the tool body 21 of many electric tools 4 has a cross-sectional shape that is at least partially convex and rounded in a vertical-horizontal plane, the lower surface 71 of the frame 70 is compatible with the tool body 21. It can also be curved in a vertical-horizontal plane to improve. The frame 70 can be configured to receive the clamp arm 36, the actuator 42, the claw 60, and the claw spring 62. The frame 70 can include a claw housing recess 72 for receiving the claw 60 and a spring mount 74 in the recess for attaching the claw spring 62 to the frame 70. The frame 70 may also be configured to attachably accept a claw cover 76 and a frame cover 78 that define the outer surfaces of the bridge 20, respectively. The frame 70 may include a main support surface 80 configured to contact the lower surface of each adjustment portion 40 of the clamp arm 36. In this regard, the main support surface 80 can define the bearing surface of the clamp arm 36. The main support surface 80 may be substantially planar as shown in the figure, but other configurations are also included within the scope of the present disclosure. The frame 70 can define each guide track of the arm 36. Each guide track may extend laterally and can guide the movement of the arm 36 along the lateral direction Y. In the embodiment shown in the figure, the guide track includes guide grooves 82 recessed from the main support surface 80 into the bridge body 68, respectively. Each guide groove 82 can be configured to receive a corresponding guide protrusion 84 on the lower surface of the adjusting portion 40 of the arm 36. The guide groove 82 and the guide protrusion 84 can have corresponding dovetail cross-sectional shapes in the vertical-longitudinal plane, in which the arm 36 is perpendicular to the frame 70 when the arm distances D1 and D2 are adjusted. It is configured to prevent movement along direction Z and / or longitudinal direction X. The frame 70 may also define a pair of abutting shoulders 86 on the sides of the bridge body 68. The contact shoulder portion 86 can be configured to come into contact with the contact protrusion 88 extending outward from the adjusting portion 40 of the arm 36 on the opposite side of the rack teeth 46. Thereby, the lateral translation of the clamp arm 36 can be restricted if necessary. The bridge 20 can be provided as a kit that includes an interchangeable clamp arm 36 with different sizes and / or configurations of different inner surfaces 38 for further adapting the bridge 20 to electric tools of different sizes and / or shapes. I want to be understood.

The frame 70 can define a vertical hole 90 for receiving the stem 64 of the actuator 42. The vertical hole 90 can have an upper hole portion 92 and a lower hole portion 94 having a diameter wider than the upper hole portion 92, and a shoulder portion 96 can be defined between them. As shown in FIG. 6, in the upper and lower hole portions 92, 94, the bottom flange 66 of the actuator 42 can be translated vertically in the lower hole portion 94, but the upper hole portion due to interference with the shoulder portion 96. It can be configured to prevent translation upwards to 92. In FIG. 6, the actuator 42 is first perpendicular to the frame 70, with the flange 66 located at the bottom of the vertical hole 90, the pinion 50 meshing with the rack teeth 46, and the claws 60 engaging the ratchet teeth 58. Shown in position. To disengage the actuator 42, the physician framed the actuator 42 by pulling the knob 54 upwards until the flange 66 abuts on the shoulder 96 so that the actuator 42 is placed in a second vertical position. Please understand that it should be moved to the second vertical position with respect to 70. In the second vertical position, the pinion 50 can be vertically separated from the rack teeth 46 and the ratchet teeth 58 can be vertically separated from the claws 60. From the second position, the physician may press the knob 54 to engage the pinion 50 and ratchet teeth 58 with the rack teeth 46 and claws 60, respectively.

It is understood that the frame 70 and the actuator 42 can be provided with a position locking mechanism that can collectively act to hold the actuator 42 in either the first vertical position or the second vertical position. I want to. For example, in the position locking mechanism, the doctor pulls upwards on the knob 54 to move the actuator 42 to a second vertical position, and then the knob 54 is quadrupled in one of the first or second rotation directions R1 and R2. The actuator 42 can be configured to be locked to a second vertical position by rotating only by rotation. To unlock the actuator 42 from the second vertical position, the doctor rotates the knob 54 in the other rotation direction R2, R1 by a quarter turn, and then pushes the knob 54 to push the actuator 42 into the first vertical position. Just move it to the position. Other position locking functions are also within the scope of this disclosure. In a further embodiment, the attachment device 34 can be disposed in the lower hole portion 94, for example, in a manner that urges the actuator 42 to a first vertical position, on the shoulder portion 96 and the bottom flange 66. It can include an urging element that can be abutted.

As shown in FIG. 5, the frame 70 may define one side recess 98 on the side surface of the frame 70 and a lateral slot 100 extending inward from the side recess 98 and opening into the vertical hole 90. The lateral slot 100 can include an upper slot portion 102 having the same lateral spread as the upper hole portion 92 and a lower slot portion 104 having the same lateral spread as the lower hole portion 94. The lower slot portion 104 may be wider than the upper slot portion 102 and may be configured to accommodate the flange 66. As a result, the actuator 42 can be laterally inserted into the vertical hole 90 through the lateral slot 100 so that the flange 66 passes through the lower slot portion 104 and the stem 64 passes through the upper slot portion 102. ..

The attachment device 34 may include an insert such as a lock clip 106 configured to hold the actuator 42 by a vertical hole 90. The lock clip 106 can define a protrusion 107 configured to extend into the lateral slot 100. The protrusion may define a portion of each of the upper hole portion 92 and the lower hole portion 94 when fully inserted into the lateral slot 100. The lock clip 106 may also define one or more portions of the guide groove 82. The lock clip 106 may also define the first mounting formation portion 108, or the opposite side surface of the frame 70 may define the second mounting formation portion 109. The first and second mounting formations 108, 109 can be configured to accept the corresponding mounting mechanism on the lower surface of the frame cover 78 for fixing the frame cover 78 to the frame 70.

Next, with reference to FIGS. 7 to 11, the assembly of the attachment device 34 of the bridge 20 will be described according to an exemplary assembly sequence. As shown in FIG. 7, the clamp arm 36 is framed so that the lower surface of the adjusting portion 40 of the arm 36 comes into contact with the main support surface 80 and the guide protrusion 84 of the arm 36 extends into the guide groove 82 of the frame 70. It can be inserted laterally into the 70. Next, referring to FIG. 8, the actuator 42 can be inserted into the vertical hole 90. As described above, the actuator 42 can be laterally inserted into the vertical hole 90 through the lateral slot 100. The actuator 42 may be positioned in a second vertical position while the actuator 42 is inserted laterally, thereby avoiding interference of the pinion 50 and ratchet teeth 58 with the rack teeth 46 and claws 60, respectively. Next, referring to FIG. 9, the claw 60 and the claw spring 62 can be mounted in the claw housing recess 72. With reference to FIG. 10, the claw cover 76 can be attached to the frame 70. The lock clip 106 can also be laterally inserted into the side recess 98 so that the protrusion 107 extends into the lateral slot 100 to complete the upper and lower hole portions 92, 94 of the vertical hole 90. As a result, the lock clip 100 can lock the actuator 42 with respect to the bridge body 68. Next, referring to FIG. 11, the frame cover 78 can be attached to the frame 70. It should be understood that other sequences of assembling the attachment device 34 are also within the scope of this disclosure.

Continuing with reference to FIG. 11, the bridge 20 may include one or more wire brackets 110 for holding the electrical wiring, cords, or cables of the distal targeting device 2. The distal end 30 of the branch portion 28 can include one or more couplers 112 for connecting to the magnetic field generator 14. As shown in the figure, each coupler 112 can include a coupler base 114 extending distally from the associated bifurcation 28. The coupler 112 can also define a tip 116 that extends laterally from the coupler base 114, respectively. Each tip 116 can define a proximal surface 118 extending orthogonally from the coupler base 114 and a tapered surface 120 extending from the proximal surface 118 to the distal surface 122 of the coupler base 114. The coupler 112 may be configured to engage the linkage of the magnetic field generator 14, as described below.

Next, referring to FIG. 12, the magnetic field generator 14 can include a front housing 130 that houses the magnetic field generator circuit. The front housing 130 may include at least a portion of a coupling element 16 configured to accommodate a portion of the shaft 6. The coupling element 16 can at least partially define an opening 132 having an opening proximal end 134 and an opening distal end 136 distally spaced apart from the opening proximal end 134. The opening 132 is open to the outside of the magnetic field generator 14 in the lateral direction T. The transverse direction T may be any direction substantially orthogonal to the longitudinal direction X. As used herein, the term "in the transverse direction" means along the transverse direction T. The opening 132 allows the shaft 6 to be inserted laterally into the coupling element 16 of the magnetic field generator 14. This allows the shaft 6 to be inserted into the magnetic field generator 14 without passing the distal or proximal ends 12 and 10 of the shaft 6 through the opening 16. This may require inserting approximately the entire length of the shaft axially through the opening in a prior art distal targeting device, distal to distal or proximal to first, with the shaft 6 being a magnetic field generator. The process of inserting into 14 can be greatly simplified. The opening 132 may also be located in the upper 138 of the front housing 130 rather than in the central region of the magnetic field generator 14. However, in other embodiments, the opening 132 may extend to the central region of the magnetic field generator 14. The upper 138 of the front housing 130 may also define a pair of receptacles 140 for receiving the coupler 112 at the distal end 30 of the branch portion 28 of the bridge 20, as described in more detail below.

The magnetic field generator 14 can define a rear housing compartment 146 between them by including a rear housing cover 142 configured to be connected to the rear surface 144 of the front housing 130. The magnetic field generator 14 may include a linkage 148 and a retainer 150 within the rear housing compartment 146. The linkage 148 can be configured to latch with the coupler 112 of the bridge 20. The retainer 150 can be configured to engage the shaft 6 and hold the shaft 6 within the opening 132. The magnetic field generator can include urging elements such as coil springs 152 configured to urge the linkage 148 and the retainer 150 to urging positions, respectively. The rear housing cover 142 can be configured to be detachably attached to the front housing 130. Thereby, the magnetic field generator 14 can, as a non-limiting example, be disassembled, or at least partially disassembled, as needed for cleaning, maintenance, and / or modification.

The linkage 148 can have a substantially plate-like body 154 having a front surface 156 and a rear surface 158 separated from each other along the longitudinal direction X. The linkage body 154 can define protrusions such as the outer guide rail 160 extending proximally from the rear surface 158. The linkage 148 can also include push elements such as a first push tab 162 extending proximally from the rear surface 158. The push tab 162 can be configured to allow the physician to move the linkage 148 laterally from the linkage urging position to the linkage pushing position. The linkage body 154 can define a recess 164 on the rear surface 158 and an opening 166 extending from the recess 164 through the linkage body 154 in the distal direction. The linkage 148 can include a pair of latches 168 extending from the top surface 170 of the linkage body 154. Each of the latches 168 can define a tapered proximal surface 172 and a distal surface 174. The latch 168 can be configured to latch with the coupler 112 of the bridge 20, as described in more detail below.

The retainer 150 can have a substantially plate-like body 176 having a front surface 178 and a rear surface 180 separated from each other along the longitudinal direction X. The retainer 150 can be configured to be at least partially located within the recess 164 of the rear surface 158 of the linkage 148. The retainer body 176 can define protrusions such as lateral guide rails 182 extending proximally from the rear surface 180. The linkage 150 can also include a pusher such as a second push tab 184 extending proximally from the rear surface 180. The second push tab 184 can be configured to allow the physician to move the retainer 150 laterally from the retainer urging position to the retainer pushing position. The retainer 150 can include a shaft mount 186 extending from the top surface 188 of the retainer body 176. The shaft mount 186 can extend distally so as to rest on the top surface 170 of the linkage body 154. The shaft mount 186 defines a bearing surface 190 configured to stabilize the bearing portion of the shaft 6 when the shaft 6 is fully inserted into the opening 132 and the retainer 150 is in the retainer urging position. Can be done.

Continuing with reference to FIG. 12, the rear housing cover 142 can define an opening 192 through which the first and second push tabs 162, 184 can pass. The front surface 194 of the rear housing cover 142 can define an elongated guide slot 196 along the lateral direction Y. The guide slot 196 receives the lateral guide rails 160 and 182 of the linkage 148 and the retainer 150, respectively, and guides the lateral movement between the urging position and the pushing position of the linkage 148 and the retainer 150, respectively. It is configured. The rear housing cover 142 may also have a socket, such as an electrical socket 198, for connecting the magnetic field generating circuit to one or more electrical wires, cords, or cables.

Next, with reference to FIG. 13, a front perspective view of the magnetic field generator 14 is shown in which the front housing 130 is shown in perspective view to show the linkage 148 and retainer 150 connected to the rear housing cover 142. The linkage 148 and the retainer 150 are shown in their respective urging positions in FIG. 13, respectively. The first mounting post 200 and the second mounting post 202 can extend distally from the front surface 194 of the rear housing cover 142. A third mounting post 204 can extend distally from the anterior surface 156 of the linkage 148. A fourth mounting post 206 can extend distally from the front surface 194 of the retainer 150 through the opening 166 of the linkage 148. The first and third mounting posts 200, 204 may be aligned substantially laterally, and both ends of one coil spring 152 can be mounted. Similarly, the second and fourth mounting posts 202, 206 may be aligned substantially laterally and can mount both ends of the other coil spring 152. Each coil spring 152 can be a tension spring configured to pull the linkage 148 and retainer 150 towards their respective urging positions.

With reference to FIG. 14, the opening 132 can be a slot 208 defined by the coupling element 16 of the magnetic field generator 14. Slot 208 can define an insertion path, also referred to as the insertion shaft 209 of the shaft 6. The insertion shaft 209 can have linear and / or curved portions. The insertion shaft 209 may extend substantially entirely along the transverse direction T. In other words, the insertion shaft 209 can be such that any line extending between any two points on the insertion shaft 209 extends substantially transversely to the longitudinal direction X. The inner end 210 of the slot 208 can define a bearing surface 212 configured to stabilize the bearing portion of the shaft 6 during operation of the power tool 4. The bearing surface 212 can be characterized as a "shaft bearing surface" or simply the "seat surface" of the magnetic field generator 14. Therefore, the inner end of the insertion shaft 209 can coincide with the shaft shaft 18 when the shaft 6 is fully seated in the slot 208. As shown in the figure, the bearing surface can be offset from the geometric center of the magnetic field generator 14 with respect to at least the transverse direction T, such as the vertical direction Z. This allows the seating surface to be located near the top of the magnetic field generator 14, making it easier to insert the shaft 6 into it. However, in other embodiments, the bearing surface can be substantially located at the geometric center of the magnetic field generator 14 (or at least at the geometric center of the magnetic field generator circuit). As shown in FIG. 14, slot 208 can include one or more linear portions 214 and one or more curved portions 216.

The bearing surface 212 can be defined by a bearing 218 located at the inner end 210 of the slot 208. In some embodiments, the bearing 218 can include a layer of low friction material. By finishing the bearing surface 212 so that the surface finish roughness is small, the friction between the bearing surface 212 and the shaft 6 can be reduced. In other embodiments, the bearing 218 may include active bearing elements such as multiple roller bearings or ball bearings dispersed along the bearing surface 212. In yet another embodiment, the bearing surface 212 can be defined by the magnetic field generator housing itself, for example by the front housing 130. In a further embodiment, the magnetic field generator 14 can use a lubrication system to lubricate the bearing surface to reduce friction with the shaft 6 during operation. It should be understood that other bearing mechanisms for the coupling element 16 of the shaft and / or magnetic field generator 14 are also within the scope of this disclosure.

Next, referring to FIG. 15, in the embodiment shown in the figure, the shaft 6 is inserted into the slot 208, so that the doctor uses the second push tab 184 to insert the retainer 150 as shown in the figure. It can be pushed to the pushed retainer position. When the shaft 6 is inserted into slot 208 and the retainer 150 is pushed to the pushed retainer position, the shaft 6 is not constrained by the retainer 150. When the physician releases the second push tab 184, the retainer 150 is urged to the retainer urging position as shown in FIGS. 16 and 17. In the retainer urging position, the shaft mount 186 is in close proximity to the shaft 6 and can optionally abut on the shaft 6. In this retainer urging position, the retainer 150 holds the shaft in a fully seated position. Similar to the bearing surface 212 of slot 208, the bearing surface 190 of the retainer 150 is for reducing friction with a layer of low friction material, surface finish, active bearing elements, lubrication, any combination of the above, or shaft 6. Any one or more of any other type of bearing mechanism can be used. The shaft 6 and the coupling element 16 cooperate so that there is a slight gap between the shaft 6 and one or more bearing surfaces 190, 212 when the shaft is fully seated. Can be configured as In another embodiment, the shaft 6 and the coupling element 16 rotate about the shaft shaft 18 in a substantially unconstrained manner, while the bearing surfaces 190, 212, as shown by the dashed line 6a. It can be configured to work together to abut one or both in the form of a bearing. In the embodiment shown in the figure, the bearing surfaces 190, 212 can substantially fix the lateral position of the shaft 6 with respect to the magnetic field generator 14 while the retainer 150 is in the urged retainer position. , Improves the accuracy of distal targeting in the distal targeting system. It should be understood that the coupling element 16 can be configured to accommodate a shaft of a diameter within a range. It should also be appreciated that the coupling element can be made larger or smaller as needed to accommodate the additional shaft 6 diameter.

Next, referring to FIG. 18, the opening 132 of the coupling element 16 may include one or more axial holding elements configured to engage the corresponding axial holding elements of the shaft. The axial holding element of the opening 132 and the shaft 6 cooperate to prevent axial movement of the shaft 6 with respect to the magnetic field generator 14, at least when the shaft 6 is fully seated in slot 208. Can be configured. As shown in the figure, the axial holding element of the opening 132 can include one or more contact surfaces of the coupling element 16. For example, the coupling element 16 can define a proximal abutting surface 220 and a distal abutting surface 222 that is distally separated from the proximal abutting surface 220. The proximal contact surface 220 can be located at the proximal end of the opening 132. The distal contact surface 220, which is distal to each of the linkage 148 and the retainer 150, can be located proximal to the distal end 136 of the opening 132. One or both of the proximal and distal contact surfaces 200 and 222 can be orthogonal to the longitudinal direction X.

Referring here to FIG. 19, the shaft 6 extends into the opening 132 and is coupled to the coupling element 16 so as to prevent the shaft 6 from translating axially with respect to the magnetic field generator 14. A bearing portion 224 configured as described above can be defined. As shown in the figure, the bearing portion 224 of the shaft can include a proximal flange 226 and a distal flange 228. The inner surfaces of the flanges 226 and 228 may be longitudinally separated from each other by a distance approximately equal to, but not less than, the longitudinal distance between the proximal abutment surface 220 and the distal abutment surface 222. it can. Thereby, when the bearing portion 224 of the shaft 6 is completely seated in the slot 208, the contact surfaces 220, 220 and the flanges 226, 288 cooperate with the axial translation of the shaft 6 with respect to the magnetic field generator. Can be prevented. This allows the axial position of the shaft 6 to be substantially fixed to the magnetic field generator 14, which further improves the accuracy of distal targeting of the distal targeting system. The lateral edge 230 of the opening 132 is continuous with the proximal and distal contact surfaces 220 and 222, respectively, so that the flanges 226 and 228 are effectively in contact with the contact surfaces 220 and 222. A guide can be formed to guide. The inner surface of one or both of the flanges 226 and 228 and the outer surface 232 of the shaft 6 between the flanges 226 and 228 are finished between the shaft 6 and the coupling element 16 by finishing so that the surface finish roughness is reduced. Friction can be reduced. In other embodiments, the bearing portion 224 of the shaft 6 may include one or more outer layers of low friction material to reduce friction between the shaft 6 and the coupling element 16. In yet another embodiment, the bearing portion 224 of the shaft 6 is, as a non-limiting example, a journal bearing, a roller bearing, a ball bearing, a thrust, in order to reduce friction between the shaft 6 and the coupling element 16. It can include one or more active bearing elements such as bearings (for flanges 226 and 228).

Next, with reference to FIG. 20, another embodiment of the axial holding element is shown. In this embodiment, the shaft 6 can define the ball flange 234 and the coupling element 16 can define at least a partially spherical groove 236 on which the ball flange 234 is seated. As described above, the coupling element 16 defines the lateral entrance opening 132a. In another embodiment, the bearing portion 224 of the shaft 6 can define a cylindrical flange configured to be seated in a cylindrical recess within the coupling element 16. However, it should be understood that the other axial holding mechanisms of the shaft 6 are also within the scope of the present disclosure.

Here, with reference to FIGS. 21 and 22, an example of a magnetic field generator 14 having a coupling element 16 having an opening 132b partially oblique to the longitudinal direction X is shown. The partially oblique opening 132b can include an oblique upper slot portion 208a and a longitudinal lower slot portion 208b (FIG. 22). In this embodiment, the longitudinal lower slot portion 208b can define the bearing surface 212. In such an embodiment, at least a portion of the shaft 6 can enter the opening 132 at an oblique angle with respect to the longitudinal direction X. The diagonal upper slot portion 208a can be configured to allow the shaft 6 to pass through the longitudinal lower slot portion 208b as the shaft 6 moves downward within the opening 132b. Since each point of the shaft 6 can move substantially in the transverse direction T as the shaft 6 is inserted into the opening 132, the partially oblique opening 132b can be characterized as a lateral entrance opening. It should be understood that the configurations of other types of lateral entrance openings are also within the scope of this disclosure.

An exemplary embodiment in which the magnetic field generator 14 is detachably connected to the bridge 20 will be described below with reference to FIGS. 23-26. As used herein, the term "detachable concatenation" and its derivatives mean repetitive concatenation and separation in a non-destructive manner. As shown in FIG. 23, the bridge 20 is directed towards the magnetic field generator 14 so that the coupler 112 at the distal end 30 of the branch portion 28 is aligned with the receptacle 140 (FIG. 12) at the top 138 of the anterior housing 130. It can be advanced distally (or the magnetic field generator 14 can be advanced proximally towards the bridge 20). As shown in FIG. 24, the bridge 20 can be further advanced into the receptacle 140 such that the coupler 112 engages the associated latch 168 of the linkage 148. As the bridge 20 continues to advance distally within the receptacle 140, the distal tapered surface 120 of the coupler 112 engages the proximal tapered surface 172 of the latch 168, translating the latch 168 laterally. As shown in FIG. 25, as the tip 116 advances distally beyond the latch 168, the linkage 148 and its latch 168 are urged to return to the linkage urging position, thereby the distal surface of the latch 168. 174 latches behind the proximal surface 118 of the tip 116, causing mechanical interference in the proximal direction. As a result, when the tip 116 advances distally beyond the latch 168, the latch 168 and the coupler 112 firmly connect the bridge 20 to the magnetic field generator 14. To disengage the coupler 112 from the latch 168, as shown in FIG. 26, the physician pushes the first push tab 162 to move the linkage 148 to the linkage push position, thereby moving the bridge 20 proximal to the magnetic field generator 14. Can be separated in direction.

Next, with reference to FIG. 27, another embodiment of the distal targeting device 1002 is shown. The distal targeting device 1002 may be similar to the distal targeting device 2 described above. The distal targeting device 1002 can include a bridge 1020 having an attachment device 1034 that can be connected to the power tool 1004. The bridge 1020 has a pair of clamp arms 1036 configured to fasten the body 1021 of the tool 1004 so as to substantially tightly connect the bridge 1020 to the electric tool 1004. The clamp arm 1036 can be placed with respect to the attachment device 1034 at an adjustable distance to allow the arm 1036 to substantially secure the tool body 1021 having one or more of different shapes and / or sizes. Is. The bridge 1020 may include a pair of branched portions 1028 that extend laterally outward on both sides of the shaft 1006 and connect to the coupling element 1016. The coupling element 1016 can be configured to hold a magnetic field generator, but the magnetic field generator is not shown in FIG.

In this embodiment, the clamp arm 1036 can be configured as a spring hinge clamp configured to urge the clamp arm 1036 against the tool body 1021. One or more of the clamp arms 1036 can be connected to the attachment device 1034 at a spring hinge 1035 defining a hinge shaft 1037 substantially oriented along the longitudinal direction X. As shown in the figure, the bridge 1020 can include two pairs of spring hinge arms 1036, but in other embodiments, the bridge 1020 can have a pair of opposing spring hinge arms 1036. As shown in FIGS. 28 and 29, in the spring hinge 1035, the clamp arm 1036 can each define a first spring mount 1039 facing a second spring mount 1041 defined by the attachment device 1034. The second spring mount 1041 can be located within the hinge recess 1043 defined by the attachment device 1034. An urging element, such as a tension spring 1045, can be attached to the first and second spring mounts 1039, 1041 in such a way that the clamp arm 1036 is urged towards a fully clamped position with respect to the tool body 1021. it can. This allows the clamp arm 1036 to securely fasten tool bodies 1021 of different sizes and / or shapes, as shown in FIG. Therefore, the tension spring 1045 can be characterized as an "actuator" for clamping the clamp arm 1036. The spring hinge 1035 can also define a toggle point, whereby the arm 1036 is optionally rotated outward beyond the toggle point to a fully open position O as shown in FIG. Be urged. As described above, the inner surface 1038 of the arm 1036 may include a layer of high friction material to increase the grip of the arm 1036 with respect to the tool body 1021. The lower 1071 of the attachment device 1034 may have an outer shape that fits the upper surface of the electric tool 1004, for example, by contouring it in a curved concave shape in a vertical-horizontal plane.

Next, with reference to FIG. 30, another embodiment of the distal targeting device 2002 is shown. The distal targeting device 2002 may be similar to the distal targeting devices 2, 1002 described above. The distal targeting device 2002 can include a bridge 2020 having an attachment device 2034 that can be connected to the power tool 2004. The bridge 2020 has a pair of clamp arms 2036 configured to fasten the body 2021 of the tool 2004 in such a manner that the bridge 2020 is substantially tightly coupled to the electric tool 2004. The clamp arm 2036 can be placed with respect to the attachment device 2034 at an adjustable distance to allow the arm 2036 to substantially secure the tool body 2021 having one or more of the different shapes and / or sizes. Is. The bridge 2020 may include a frame 2070 that supports the attachment device 2034. The bridge 2020 may include a pair of branching portions 2028 that extend laterally outward on both sides of the shaft 2006 and connect to the coupling element 2016. The coupling element 2016 can be configured to hold a magnetic field generator, but the magnetic field generator is not shown in FIG.

Next, referring to FIG. 31, each clamp arm 2036 can be connected to the frame 2070 at a respective pivot joint such as a hinge 2035. Each hinge 2035 can define a hinge shaft 2037 around which the clamp arm 2036 rotates. Each hinge shaft 2037 can be oriented substantially along the longitudinal direction X. Each clamp arm 2036 can define a first portion 2039 extending from the hinge 2035 to the tool body 2021. The first portion 2039 of the arm 2036 can define an inner tool contact surface 2038 configured to contact the tool body 2021. As described above, the inner tool contact surface 2038 of the arm 2036 may include a layer of high friction material to increase the grip of the arm 2036 to the tool body 2021. The clamp arm 2036 can also define a second portion 2041 extending from the hinge 2035 to an actuator such as the translational member 2050 of the attachment device 2034. The second portion 2041 of the clamp arm 2036 can define an inner working contact surface 2043 configured to engage the translational member 2050. It should be appreciated that the attachment device 2034 may optionally include a cover (not shown) such as an upper folding cover to cover at least a portion of the translation member 2050 and the clamp arm 2036.

With reference to FIG. 30 again, the translation member 2050 can be configured to translate along the translation axis 2056 in such a way that the inner tool contact surface 2038 of the clamp arm 2036 is urged against the tool body 2021. .. As shown in the figure, the translation axis 2056 can be oriented along the longitudinal direction X, but other orientations are also possible. The translation member 2050 can include a knob 2055 that facilitates the operation of the translation member 2050. The translation member 2050 can define one or more outer contact surfaces 2051 configured to engage the inner working contact surface 2043 of the arm 2036. As shown in the figure, one or more of the outer contact surfaces 2051 of the translational member 2050 can be oblique with respect to the longitudinal direction X in such a way as to give the translational member 2050 a wedge-shaped configuration. As shown in the figure, the outer contact surface 2051 can be tapered inward along the proximal direction. One or more inner working contact surfaces 2043 of the arm 2036 can also be oblique with respect to longitudinal direction X. At least a portion of the inner working contact surface 2043 can be conical in shape with increasing width along the proximal direction. The outer contact surface 2051 of the translation member 2050 and the inner working contact surface 2043 of the arm 2036 are such that the doctor translates the translation member 2050 in the first translation direction X1 to urge the inner working contact surface 2043 laterally outward. (Therefore, the inner tool contact surface 2038 can be configured to collaborate laterally inward via a hinge). In the embodiment shown in the figure, the first translational direction X1 is the proximal direction.

The attachment device 2034 may include a ratchet configured to prevent the arm 2036 from moving laterally outward after the arm 2036 has been clamped to the tool body 2021. The ratchet can include ratchet teeth 2058 arranged linearly along one or more ratchet tracks on the outside of the translational member 2050. The ratchet allows the translation member 2050 to translate along the first translation direction X1 while preventing translation along the second translation direction X2 opposite to the first translation direction X1. It can include one or more claws 2060 configured to engage the ratchet teeth 2058 in shape. Each one or claw 2060 can rotate along the claw shaft 2063. Each one or claw 2060 may include a tab that allows the claw 2060 to be manually disengaged from the ratchet teeth 2058.

As shown in FIGS. 30, 32, and 33, the coupling element 2016 of this embodiment can define a mounting bracket 2017 configured to detachably mount the magnetic field generator. The coupling element 2016 can define a lateral entrance opening 2132 similar to that described above. Next, referring to FIG. 33, the coupling element 2016 can include a shaft mount 2186 having a groove 2187 in which the shaft 2006 can be seated when the shaft 2006 is also fully seated in the opening 2132. The shaft mount 2186 can include a bearing surface 2190 in the groove 2187. In this embodiment, the shaft mount 2186 can be a flexible linkage of the coupling element 2016. The shaft mount 2186 can include a button 2189 that allows the opening 2132 to be manually pushed in such a way that the shaft 2006 can be guided into the groove 2187 to bend the shaft mount 2186 downward, for example. When the button 2189 is released, the shaft mount 2186 bends upward, for example, to a position where the shaft 2006 is fully seated in the groove 2187 and engages the bearing surface 2189.

Coupling elements 16, 1016, 2016 disclosed herein represent non-limiting examples of coupling elements that can be used to laterally insert and connect a shaft to a magnetic field generator. I want you to understand.

Then referring to FIGS. 34 and 35, the coupling element 2016 can include a linkage such as one or more lateral pins 2168 extending within a pair of receptacles 2140 proximal to the coupling element 2016. .. The distal end of each branch can define a coupler recess 2112 configured to accept the lateral pin 2186 in such a way that the bridge 2020 is substantially tightly coupled to the coupling element 2016.

Here, with reference to FIGS. 36-39, another embodiment of the distal targeting device 3002 is shown. As shown in FIG. 36, the distal targeting device 3002 can include a bridge 3020 having a branch portion 3028 connected to a magnetic field generator 3014. The magnetic field generator 3014 has a lateral inlet opening 3132 for receiving the shaft of the electric tool 3004 connected to the distal targeting device 3002. The shaft bearing surface can be located substantially at the geometric center of the magnetic field generator 3014. In the present embodiment, the branch-shaped portion 3028 surrounds both sides of the electric tool 3004 like brackets by the attachment device 3034 of the bridge 3020. The attachment device 3034 may include a tether 3040. The branching portion 3028 may include a coupler such as a cleat 3030 extending laterally outward from the branching portion 3028 in a proximal portion of the branching portion 3028 or the like. The tether 3040 is configured to connect the branch portion 3028 to the attachment device 3024 by being connected to the cleat 3030. FIG. 36 shows the tether 3040 loosely tied to the cleat 3030, and FIG. 37 shows the tether in a tightened form.

The attachment device 3034 has a mount 3070 configured to be attached to a portion of an electric tool, such as the top of a motor cowling. Mount 3070 can be configured to secure the tether 3040. The tether 3040 can extend from the tensioning mechanism 3050. The tension applying mechanism 3050 can be detachably attached to the mount 3070. The tensioning mechanism 3050 can include a dial 3052 rotatably connected to the base 3054. The mount 3070 can define a mount surface 3055 for supporting the base 3054 of the tensioning mechanism 3050. The mount 3070 can also include a first coupling element, such as a tab 3060 configured to be detachably connected to the base 3054 in a snap-fitting manner, for example.

As shown in FIG. 36, the dial 3052 can define a rotating shaft 3053. The dial 3052 can be connected to an internal spool around which the tether 3040 is wound. The tension applying mechanism 3050 is configured so that the tether 3040 is further wound around the spool when the spool (via the dial 3052) is rotated with respect to the base 3054 in the first rotation direction about the shaft 3053. This allows tension to be applied to the tether 3040 and reduces the overall length of the tether 3040 extending from the tensioning mechanism 3050. The tensioning mechanism 3050 may include a ratchet, which prevents the spool and / or dial 3052 from rotating in a second rotation direction opposite to the first rotation direction when the ratchet is engaged. .. The ratchet can be engaged and disengaged, for example, by continuously pressing the dial 3052.

As shown in FIG. 39, the mount 3070 can define a second coupling element, such as a fixed slot 3080 recessed from the mount surface 3055. The most distal one of the fixed slots 3080 can be at least partially defined by the anterior tab 3065. The fixed slot 3080 can be configured to accommodate a portion of the tether 3040. For example, the tether is pulled out of the tensioning mechanism 3050 or at least loosened and passed through one or more of the fixing slots 3080, optionally all, to secure the branch portion 3028 to the mount 3070. One or more of the cleats 3030 can be optionally wrapped around all around. The tension applying mechanism 3050 can be connected to the mount surface 3055 of the mount 3070 via the tab 3060 by snap fitting. The mount surface 3055 can be tilted distally at an acute angle α with respect to the shaft axis 18 (see FIG. 1) to improve physician access. The dial 3052 can then be rotated in the first rotational direction until the tether 3040 tightens the branch portion 3028 against the power tool 3004. As shown in FIG. 38, the branch portion 3028 of this embodiment is adjustable laterally as much as necessary to fit, for example, the electric tools 3004 of different sizes and / or shapes. In this embodiment, the branch portion 3028 itself can be characterized as a clamp arm of the attachment device 3024.

An exemplary embodiment of the display assembly 300 for use with the distal targeting apparatus described above will then be described with reference to FIGS. 40-42. As shown in FIG. 40, the display assembly 300 can include a display 302 connected to an arm such as a joint motion arm 304 as shown in the figure. The joint movement arm 304 can be formed by a plurality of joint movement possible arm segments 306 connected to each other. The arm 304 can also include a fixed segment 308 for connecting to a distal targeting device. As shown in FIG. 41, the display 302 is located relative to the distal end of the shaft 6 and, as a non-limiting example, an item targeted by a distal targeting device, such as an intramedullary nail lock screw. A view screen 301 that provides a visual sign 310 can be included. As shown in FIG. 42, the display assembly 300 can be connected to the bridge 20 of the distal targeting device 2. In other embodiments, the display assembly 300, or at least the display 302, can be connected to an operating table, bench, or another location within the physician's field of view during the distal targeting procedure.

Although this disclosure has been described in detail, it is understood that various modifications, substitutions, and modifications may be made herein without departing from the spirit and scope of the invention as defined by the appended claims. Should be done. Moreover, the scope of the present disclosure is not limited to the particular embodiments described herein. As one of ordinary skill in the art will readily understand from the process, it will either perform substantially the same function as the corresponding embodiment described herein, or achieve substantially the same result, currently present or later. Machines, manufacturing methods, compositions, means, methods, or processes developed may be utilized in accordance with the present disclosure.

[Implementation]
(1) A distal targeting device for surgical instruments.
A magnetic field generator with a coupling element configured to accept an elongated shaft along the axis,
It has an attachment device that is a bridge that can be connected to the magnetic field generator so as to be separated from the magnetic field generator in the proximal direction with respect to the axis and that can be connected to a tool configured to operate the shaft. A bridge comprising a pair of arms configured to fasten the body of the tool in such a manner that the bridge is substantially tightly coupled to the tool, wherein at least one of the arms is different. A distal targeting device in which a tool body having one or more of shapes and sizes can be placed with respect to the attachment member at an adjustable distance so that the arm is substantially able to fasten.
(2) The rotation of the pinion is such that at least one of the pair of arms defines a rack having teeth and the attachment device comprises a pinion configured to engage the teeth of the rack. The distal targeting device according to embodiment 1, wherein the distance is increased or decreased.
(3) The distal targeting device according to embodiment 2, wherein the pinion is connected to a knob configured to allow a physician to operate the pinion.
(4) The knob defines a ratchet tooth, the attachment device comprises at least one claw configured to engage the ratchet tooth, and the at least one claw 1) reduces the distance. As described above, the pinion can be rotated along the first rotation direction, and 2) the pinion is prevented from rotating along the second rotation direction opposite to the first rotation direction. The distal targeting apparatus according to embodiment 3.
(5) The attachment device includes a tether engaged with a tension applying mechanism, the tether is configured to be attached to at least one of the arms, and the tension applying mechanism applies tension to the tether. The distal targeting device according to embodiment 1, which is configured to reduce the distance.

(6) Each of the pair of arms defines one or more cleats, and the tether is attached to each of the arms by being tied around the one or more cleats of each of the arms. The distal targeting apparatus according to embodiment 5, wherein the tension applying mechanism is configured to apply tension to the tether to reduce the distance.
(7) The distance according to embodiment 6, wherein the tension applying mechanism includes a dial, and the tether is wound around a spool connected to the dial so that the rotation of the dial applies the tension to the tether. Position targeting device.
(8) The attachment device includes a translatable member that can be translated along a translation axis, the translatable member has a member contact surface, and at least one of the arms engages with the member contact surface. An arm contact surface is defined, and at least one of the member contact surface and the arm contact surface is oriented at an oblique angle with respect to the translation axis, and the translatable member in the first translation direction along the translation axis. The distal targeting device according to embodiment 1, wherein the translation moves at least one of the arms to reduce the distance.
(9) The translatable member defines a ratchet tooth, the attachment device comprises at least one claw that engages the ratchet tooth, and the at least one claw is 1) said first of the translatable member. 8), which is configured to enable translation in the translational direction of, and 2) prevent translation of the translatable member in a second translational direction opposite to the first translational direction. Distal targeting device according to.
(10) The arm includes a first arm portion configured so that at least one of the arms abuts on the main body of the tool, and a second arm portion defining the arm contact surface. The first arm by reducing the distance by allowing at least one of the pivots to be pivoted around a pivot joint located between the first arm portion and the second arm portion. 8. The distal targeting device according to embodiment 8, wherein the portion is pivoted relative to the body of the tool.

(11) The first embodiment, wherein at least one of the arms is connected to the attachment device by a spring hinge configured to urge the at least one of the arms against the body of the tool. Distal targeting device.
(12) An embodiment in which each of the pair of arms is connected to the attachment device by a spring hinge configured to urge the pair of arms against both sides of the body of the tool. 11. The distal targeting device according to 11.
(13) A second pair of arms configured such that the bridge cooperates with the pair of arms to fasten the body of the tool in such a manner that the bridge is substantially firmly connected to the tool. Each arm of the pair of arms and the second pair of arms allows the arms to substantially secure a tool body having one or more of different shapes and sizes. It can be placed with respect to the attachment member at an adjustable distance so that each of the second pair of arms urges the second pair of arms against both sides of the body of the tool. 12. The distal targeting device according to embodiment 12, which is connected to the attachment device by each of the configured spring hinges.
(14) A magnetic field generator configured to align the target with the shaft of the surgical instrument.
A housing that houses the magnetic field generation circuit and
A coupling element that at least partially defines an opening, wherein the opening has a proximal end of the opening and a distal end of the opening that are spaced apart from each other along the longitudinal direction. A coupling element that accepts the shaft without passing the distal or proximal end of the shaft through the opening by opening laterally substantially perpendicular to the longitudinal direction.
A magnetic field generator equipped with.
(15) The opening is a slot having a first slot portion communicating with the second slot portion, the first slot portion is open in the lateral direction, and the second slot portion is The magnetic field generator according to embodiment 14, wherein the inner end of the opening is defined and the second slot portion is separated from the first slot portion.

(16) A shaft mount movably arranged in the housing is further provided, and the shaft mount is configured to move between a first position and a second position. 1) The first position. The magnetic field generator according to embodiment 14, wherein in position the shaft mount holds the shaft in the opening and 2) in the second position the shaft is not constrained by the shaft mount.
(17) The magnetic field generator according to embodiment 16, wherein at least one of the opening and the shaft mount includes a bearing surface for rotatably supporting the shaft.
(18) The magnetic field generator according to embodiment 14, wherein the coupling element defines a shaft bearing surface that communicates with the opening.
(19) In embodiment 18, the shaft bearing surface is substantially located at the geometric center of the magnetic field generating circuit or is vertically offset from the geometric center of the magnetic field generating circuit. The magnetic field generator described.
(20) A distal targeting system
An electric tool with a tool body and receiving elements,
A shaft that is elongated along an axis extending along the longitudinal direction, the proximal portion of the shaft being receptible within the receiving element, and the shaft.
A magnetic field generator with a coupling element configured to accept the shaft,
A bridge that can be connected to the magnetic field generator in a direction proximal to the axis so as to be separated from the magnetic field generator and has an attachment device that can be connected to a drive tool, and the bridge is substantially attached to the tool. It comprises a bridge comprising a pair of arms configured to fasten the tool body in such a way that it is tightly coupled, and at least one of the arms has the arm 1) substantially the tool body. 2) Release the tool body, and 3) make it possible to substantially firmly hold the second tool body having one or more of a size and shape different from the tool body. A distal targeting system that can be placed with respect to the attachment device at an adjustable distance.

(21) The distal targeting system according to embodiment 20, wherein the attachment device comprises an actuator configured to adjust the distance by rearranging at least one of the arms.
(22) The magnetic field generator further comprises a linkage, the bridge further comprises one or more couplers located at the distal end of the bridge, and the linkage is attached to and detached from the one or more couplers of the bridge. 20. The distal targeting system according to embodiment 20, which is connectable as possible.

Claims (22)

A distal targeting device for surgical instruments
A magnetic field generator with a coupling element configured to accept an elongated shaft along the axis,
It has an attachment device that is a bridge that can be connected to the magnetic field generator so as to be separated from the magnetic field generator in the proximal direction with respect to the axis and that can be connected to a tool configured to operate the shaft. A bridge comprising a pair of arms configured to fasten the body of the tool in such a manner that the bridge is substantially tightly coupled to the tool, wherein at least one of the arms is different. A distal targeting device in which a tool body having one or more of shapes and sizes can be placed with respect to the attachment member at an adjustable distance so that the arm is substantially able to fasten. The rotation of the pinion increases the distance by defining a rack in which at least one of the pair of arms has teeth and the attachment device comprises a pinion configured to engage the teeth of the rack. The distal targeting device according to claim 1, wherein the distal targeting device is made or reduced. The distal targeting device of claim 2, wherein the pinion is coupled to a knob configured to allow a physician to operate the pinion. The knob defines a ratchet tooth, the attachment device comprises at least one claw configured to engage the ratchet tooth, and the at least one claw 1) reduces the distance. It is configured to enable the rotation of the pinion along the rotation direction of 1 and 2) prevent the rotation of the pinion along the second rotation direction opposite to the first rotation direction. The distal targeting device according to claim 3. The attachment device comprises a tether engaged with a tensioning mechanism, the tether being configured to be attached to at least one of the arms, the tensioning mechanism applying tension to the tether to the distance. The distal targeting device according to claim 1, which is configured to reduce. Each of the pair of arms defines one or more cleats, and the tether is tied around the one or more cleats of each of the arms to attach the tether to each of the arms. The distal targeting apparatus according to claim 5, wherein the tension applying mechanism is configured to apply tension to the tether to reduce the distance. The distal targeting apparatus according to claim 6, wherein the tension applying mechanism comprises a dial, and the rotation of the dial applies the tension to the tether by winding the tether around a spool connected to the dial. .. The attachment device comprises a translatable member that can be translated along a translation axis, the translatable member has a member contact surface, and at least one of the arms engages with the member contact surface. At least one of the member contact surface and the arm contact surface is oriented at an oblique angle with respect to the translation axis, and the translation of the translatable member in the first translation direction along the translation axis is performed. The distal targeting device of claim 1, wherein at least one of the arms is moved to reduce the distance. The translatable member defines a ratchet tooth, the attachment device comprises at least one claw that engages the ratchet tooth, and the at least one claw is 1) the first translation direction of the translatable member. 8. The claim 8 is configured to allow translation to and 2) prevent translation of the translatable member in a second translation direction opposite to the first translation direction. Distal targeting device. At least one of the arms includes a first arm portion configured to abut the body of the tool and a second arm portion defining the arm contact surface. However, since the first arm portion can be pivoted around the pivot joint located between the first arm portion and the second arm portion, the first arm portion can be moved by reducing the distance. The distal targeting device of claim 8, which pivots relative to said body of the tool. The distal according to claim 1, wherein at least one of the arms is connected to the attachment device by a spring hinge configured to urge the at least one of the arms against the body of the tool. Targeting device. 11. The 11th aspect, wherein each of the pair of arms is connected to the attachment device by a spring hinge configured to urge the pair of arms against both sides of the body of the tool. Distal targeting device. The bridge further comprises a second pair of arms configured to fasten the body of the tool in cooperation with the pair of arms such that the bridge is substantially tightly coupled to the tool. Each arm of the pair of arms and the second pair of arms can be adjusted to allow the arms to substantially secure a tool body having one or more of different shapes and sizes. It can be placed with respect to the attachment member at a distance, and each of the second pair of arms is configured to urge the second pair of arms against both sides of the body of the tool. The distal targeting device according to claim 12, which is connected to the attachment device by each spring hinge. A magnetic field generator configured to align the target with the shaft of the surgical instrument.
A housing that houses the magnetic field generation circuit and
A coupling element that at least partially defines an opening, wherein the opening has a proximal end of the opening and a distal end of the opening that are spaced apart from each other along the longitudinal direction. A coupling element that accepts the shaft without passing the distal or proximal end of the shaft through the opening by opening laterally substantially perpendicular to the longitudinal direction.
A magnetic field generator equipped with. The opening is a slot having a first slot portion communicating with the second slot portion, the first slot portion is open in the lateral direction, and the second slot portion is the opening. 14. The magnetic field generator of claim 14, wherein the inner end of the is defined and the second slot portion is separated from the first slot portion. A shaft mount movably disposed in the housing is further provided, and the shaft mount is configured to move between a first position and a second position. 1) In the first position The magnetic field generator according to claim 14, wherein the shaft mount holds the shaft in the opening, and 2) the shaft is not constrained by the shaft mount in the second position. The magnetic field generator according to claim 16, wherein at least one of the opening and the shaft mount includes a bearing surface for rotatably supporting the shaft. 14. The magnetic field generator of claim 14, wherein the coupling element defines a shaft bearing surface that communicates with the opening. 18. The magnetic field according to claim 18, wherein the shaft bearing surface is substantially located at the geometric center of the magnetic field generating circuit or is vertically offset from the geometric center of the magnetic field generating circuit. Generator. Distal targeting system
An electric tool with a tool body and receiving elements,
A shaft that is elongated along an axis extending along the longitudinal direction, the proximal portion of the shaft being receptible within the receiving element, and the shaft.
A magnetic field generator with a coupling element configured to accept the shaft,
A bridge that can be connected to the magnetic field generator in a direction proximal to the axis so as to be separated from the magnetic field generator and has an attachment device that can be connected to a drive tool, and the bridge is substantially attached to the tool. It comprises a bridge comprising a pair of arms configured to fasten the tool body in such a way that it is tightly coupled, and at least one of the arms has the arm 1) substantially the tool body. 2) Release the tool body, and 3) make it possible to substantially firmly hold the second tool body having one or more of a size and shape different from the tool body. A distal targeting system that can be placed with respect to the attachment device at an adjustable distance. 20. The distal targeting system of claim 20, wherein the attachment device comprises an actuator configured to adjust the distance by rearranging the at least one arm. The magnetic field generator further comprises a linkage, the bridge further comprises one or more couplers located at the distal end of the bridge, and the linkage is detachably connected to the one or more couplers of the bridge. The distal targeting system of claim 20, which is possible.

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